title: Hyperechoic appearance of hepatic parenchyma on ultrasound examination of patients with blunt hepatic injury.
abstract: OBJECTIVE
  To study the significance of a geographic hyperechoic liver parenchyma pattern on ultrasound (US) examination of patients with blunt abdominal injury.
  
  
  METHODS
  Prospective clinical study with double-blind evaluation of images and clinical data.
  
  
  RESULTS
  We performed US examinations in 831 consecutive patients admitted to our hospital for blunt abdominal trauma and identified 33 with a geographic hyperechoic pattern in the liver. We correlated the appearance with computed tomographic images and with clinical, angiographic, and scintigraphic data. All patients with a geographic hyperechoic pattern showed mild computed tomographic evidence of hepatic injury (Mirvis grade 2, 69%; Mirvis grade 3, 31%). Excluding patients who required urgent surgery for other reasons and patients in shock, patients with the geographic hyperechoic pattern were managed conservatively with no complications.
  
  
  CONCLUSIONS
  The geographic hyperechoic pattern of liver parenchyma on US examination of trauma patients is a mild injury that, of itself, does not require surgical therapy.
authors.affiliation: Department of Traumatology and Critical Care Medicine, Kyorin University School of Medicine, Tokyo, Japan.
authors.forename: S
authors.initials: S
authors.lastname: Ohta
authors.forename: A
authors.initials: A
authors.lastname: Hagiwara
authors.forename: T
authors.initials: T
authors.lastname: Yukioka
authors.forename: S
authors.initials: S
authors.lastname: Ohta
authors.forename: K
authors.initials: K
authors.lastname: Ikegami
authors.forename: H
authors.initials: H
authors.lastname: Matsuda
authors.forename: S
authors.initials: S
authors.lastname: Shimazaki
mesh_terms: D000293:Adolescent; D000328:Adult; D000792:Angiography; D003663:Decision Trees; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D015601:Injury Severity Score; D008099:Liver / Q000000981:diagnostic imaging* / Q000293:injuries*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011877:Radionuclide Imaging; D015203:Reproducibility of Results; D014057:Tomography, X-Ray Computed; D014463:Ultrasonography; D014949:Wounds, Nonpenetrating / Q000000981:diagnostic imaging* / Q000209:etiology / Q000601:surgery